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https://www.readbyqxmd.com/read/29239575/what-s-at-stake-states-progress-on-health-coverage-and-access-to-care-2013%C3%A2-2016
#1
Susan L Hayes, Sarah R Collins, David C Radley, Douglas McCarthy
Issue: Given uncertainty about the future of the Affordable Care Act, it is useful to examine the progress in coverage and access made under the law. Goal: Compare state trends in access to affordable health care between 2013 and 2016. Methods: Analysis of recent data from the U.S. Census Bureau and the Behavioral Risk Factor Surveillance System. Findings and Conclusions: Between 2013 and 2016, the uninsured rate for adults ages 19 to 64 declined in all states and the District of Columbia, and fell by at least 5 percentage points in 47 states...
December 1, 2017: Issue Brief of the Commonwealth Fund
https://www.readbyqxmd.com/read/29239203/access-through-altruism-a-community-based-free-outpatient-surgery-program-for-the-working-poor-in-the-united-states
#2
Heather R Nolan, Benjamin Christie
Despite healthcare reform, a large population in the United States is without healthcare coverage. The Surgery for People in Need (SPIN) program offers free outpatient surgical procedures to working, uninsured adults. Taking nearly one year to construct, the program has been operational for three years and has performed 22 procedures. Free surgery programs can improve healthcare access by providing interventions to patients who otherwise have no outlet for surgical care.
June 2017: Journal of Perioperative Practice
https://www.readbyqxmd.com/read/29237493/the-association-between-health-insurance-status-and-utilization-of-health-services-in-rural-northern-ghana-evidence-from-the-introduction-of-the-national-health-insurance-scheme
#3
Philip Ayizem Dalinjong, Paul Welaga, James Akazili, Anthony Kwarteng, Martin Bangha, Abraham Oduro, Osman Sankoh, Jane Goudge
BACKGROUND: Many households in low- and middle-income countries face financial hardships due to payments for health care, while others are pushed into poverty. Risk pooling and prepayment mechanisms help to lessen the impact of the costs of care as well as assisting to achieve universal health coverage (UHC). Ghana implemented the National Health Insurance Scheme (NHIS) for the promotion of access to health services for all Ghanaians. In this paper, we examined the association between health insurance status and utilization of outpatient and inpatient health services in rural poor communities...
December 13, 2017: Journal of Health, Population, and Nutrition
https://www.readbyqxmd.com/read/29237143/trends-in-health-insurance-coverage-of-title-x-family-planning-program-clients-2005-2015
#4
Emily J Decker, Katherine A Ahrens, Christina I Fowler, Marion Carter, Loretta Gavin, Susan Moskosky
BACKGROUND: The federal Title X Family Planning Program supports the delivery of family planning services and related preventive care to 4 million individuals annually in the United States. The implementation of the 2010 Affordable Care Act's (ACA's) Medicaid expansion and provisions expanding access to health insurance, which took effect in January 2014, resulted in higher rates of health insurance coverage in the U.S. population; the ACA's impact on individuals served by the Title X program has not yet been evaluated...
December 13, 2017: Journal of Women's Health
https://www.readbyqxmd.com/read/29237095/pharmacist-physician-collaborative-care-model-and-time-to-goal-blood-pressure-in-the-uninsured-population
#5
Dave L Dixon, Evan M Sisson, Eric D Parod, Benjamin W Van Tassell, Pramit A Nadpara, Daniel Carl, Alan W Dow
Pharmacist-physician collaborative practice models (PPCPMs) improve blood pressure (BP) control, but their effect on time to goal BP is unknown. This retrospective cohort study evaluated the impact of a PPCPM on time to goal BP compared with usual care using data from existing medical records in uninsured patients with hypertension. The primary outcome was time from the initial visit to the first follow-up visit with a BP <140/90 mm Hg. The study included 377 patients (259 = PPCPM; 118 = usual care)...
December 13, 2017: Journal of Clinical Hypertension
https://www.readbyqxmd.com/read/29233720/a-pragmatic-randomized-comparative-effectiveness-trial-of-transitional-care-for-a-socioeconomically-diverse-population-design-rationale-and-baseline-characteristics
#6
Christine Schaeffer, Caroline Teter, Emily A Finch, Courtney Hurt, Mary Kate Keeter, David T Liss, Angela Rogers, Avani Sheth, Ronald Ackermann
Transitional care programs have been widely used to reduce readmissions and improve the quality and safety of the handoff process between hospital and outpatient providers. Very little is known about effective transitional care interventions among patients who are uninsured or with Medicaid. This paper describes the design and baseline characteristics of a pragmatic randomized comparative effectiveness trial of transitional care. Northwestern Medical Group- Transitional Care (NMG-TC) care model was developed to address the needs of patients with multiple medical problems that required lifestyle changes and were amenable to office-based management...
December 9, 2017: Contemporary Clinical Trials
https://www.readbyqxmd.com/read/29232088/comparing-the-affordable-care-act-s-financial-impact-on-safety-net-hospitals-in-states-that-expanded-medicaid-and-those-that-did-not
#7
Allen Dobson, Joan E DaVanzo, Randy Haught, Luu Phap-Hoa
Issue: Safety-net hospitals play a vital role in delivering health care to Medicaid enrollees, the uninsured, and other vulnerable patients. By reducing the number of uninsured Americans, the Affordable Care Act (ACA) was also expected to lower these hospitals’ significant uncompensated care costs and shore up their financial stability. Goal: To examine how the ACA’s Medicaid expansion affected the financial status of safety-net hospitals in states that expanded Medicaid and in states that did not...
November 1, 2017: Issue Brief of the Commonwealth Fund
https://www.readbyqxmd.com/read/29226450/barriers-to-care-among-transgender-and-gender-nonconforming-adults
#8
Gilbert Gonzales, Carrie Henning-Smith
Policy Points: Transgender and gender nonconforming (GNC) adults may experience barriers to care for a variety of reasons, including discrimination and lack of awareness by providers in health care settings. In our analysis of a large, population-based sample, we found transgender and GNC adults were more likely to be uninsured and have unmet health care needs, and were less likely to have routine care, compared to cisgender (nontransgender) women. Our findings varied by gender identity. More research is needed on transgender and GNC populations, including on how public policy and provider awareness affects health care access and health outcomes differentially by gender identity...
December 2017: Milbank Quarterly
https://www.readbyqxmd.com/read/29225931/community-preferences-for-a-social-health-insurance-benefit-package-an-exploratory-study-among-the-uninsured-in-vietnam
#9
Hoa Thi Nguyen, Tinh Viet Luu, Gerald Leppert, Manuela De Allegri
Understanding public preferences in terms of health benefit packages (HBPs) remains limited, yet gathering community insights is an important endeavour when developing people-centred health systems and moving towards universal health coverage. Our study aimed to address this gap in knowledge by eliciting community preferences for the social health insurance benefit package among the uninsured in Vietnam. We adopted a mixed methods approach that included a ranking exercise followed by focus group discussions...
2017: BMJ Global Health
https://www.readbyqxmd.com/read/29224224/healthy-and-ready-to-learn-effects-of-a-school-based-public-health-insurance-outreach-program-for-kindergarten-aged-children
#10
Jade Marcus Jenkins
BACKGROUND: Rates of child insurance coverage have increased due to expansions in public programs, but many eligible children remain uninsured. Uninsured children are less likely to receive preventative care, which leads to poorer health and achievement in the long term. This study is an evaluation of a school-based health insurance outreach initiative, "Healthy and Ready to Learn," aiming to identify and enroll uninsured kindergarteners in areas of high economic need in 16 counties in North Carolina...
January 2018: Journal of School Health
https://www.readbyqxmd.com/read/29219921/colorectal-cancer-safety-net-is-it-catching-patients-appropriately
#11
Alison R Althans, Justin T Brady, Melissa L Times, Deborah S Keller, Alexis R Harvey, Molly E Kelly, Nilam D Patel, Scott R Steele
BACKGROUND: Disparities in access to colorectal cancer care are multifactorial and are affected by socioeconomic elements. Uninsured and Medicaid patients present with advanced stage disease and have worse outcomes compared with similar privately insured patients. Safety net hospitals are a major care provider to this vulnerable population. Few studies have evaluated outcomes for safety net hospitals compared with private institutions in colorectal cancer. OBJECTIVE: The purpose of this study was to compare demographics, screening rates, presentation stage, and survival rates between a safety net hospital and a tertiary care center...
January 2018: Diseases of the Colon and Rectum
https://www.readbyqxmd.com/read/29210831/correlates-of-linkage-to-hiv-pre-exposure-prophylaxis-prep-among-hiv-testing-clients
#12
Charlene A Flash, Oluwatobi O Adegboyega, Xiaoying Yu, Carmen Avalos, Syundai Johnson, Kenneth H Mayer, Thomas P Giordano
BACKGROUND: Publicly funded HIV testing sites can identify HIV pre-exposure prophylaxis (PrEP) candidates and provide PrEP linkage. SETTING: Harris Health System's HIV clinic, HIV testing program and HIV Prevention Program in Houston, TX, a high HIV incidence city. METHODS: A prospective assessment of individuals ≥18 years old recruited from walk-in HIV testing December, 2013 to April, 2015 included risk assessment, HIV testing and self-administered survey, with follow-up surveys at 6 and 12 months and medical record review...
November 27, 2017: Journal of Acquired Immune Deficiency Syndromes: JAIDS
https://www.readbyqxmd.com/read/29204975/characteristics-and-disparities-among-primary-care-practices-in-the-united-states
#13
David Michael Levine, Jeffrey A Linder, Bruce E Landon
BACKGROUND: Despite new incentives for US primary care, concerns abound that patient-centered practice capabilities are lagging. OBJECTIVE: Describe the practice structure, patient-centered capabilities, and payment relationships of US primary care practices; identify disparities in practice capabilities. DESIGN: Analysis of the 2015 Medical Organizations Survey (MOS), part of the nationally representative Medical Expenditure Panel Survey (MEPS)...
December 4, 2017: Journal of General Internal Medicine
https://www.readbyqxmd.com/read/29200356/marketplace-plans-provide-risk-protection-but-actuarial-values-overstate-realized-coverage-for-most-enrollees
#14
Maria Polyakova, Lynn Mei Hua, M Kate Bundorf
The Affordable Care Act (ACA) has increased the number of Americans with health insurance. Yet many policy makers and consumers have questioned the value of Marketplace plan coverage because of the generally high levels of cost sharing. We simulated out-of-pocket spending for bronze, silver, or gold Marketplace plans (those having actuarial values of 60 percent, 70 percent, and 80 percent, respectively). We found that for the vast majority of consumers, the proportion of covered spending paid by the plans is likely to be far less than their actuarial values, the metric commonly used to convey plan generosity...
December 2017: Health Affairs
https://www.readbyqxmd.com/read/29200332/medicaid-expansion-and-marketplace-eligibility-both-increased-coverage-with-trade-offs-in-access-affordability
#15
Thomas M Selden, Brandy J Lipton, Sandra L Decker
Affordable Care Act (ACA) provisions implemented in 2014 provide a valuable case study regarding the merits of using public versus subsidized private insurance to help low-income people obtain and finance health care. In particular, nonelderly adults with incomes of 100-138 percent of the federal poverty level gained Medicaid eligibility if they lived in states that implemented the ACA's Medicaid expansion, whereas those in nonexpansion states became eligible for subsidized Marketplace coverage. Using data for 2008-15 from the National Health Interview Survey, we found that as of 2015, adults with family incomes in this range had experienced large declines in uninsurance rates in both expansion and nonexpansion states (the adjusted declines were 22 percentage points and 18 percentage points, respectively)...
December 2017: Health Affairs
https://www.readbyqxmd.com/read/29200330/the-uninsured-do-not-use-the-emergency-department-more-they-use-other-care-less
#16
Ruohua Annetta Zhou, Katherine Baicker, Sarah Taubman, Amy N Finkelstein
There is a popular perception that insurance coverage will reduce overuse of the emergency department (ED). Both opponents and advocates of expanding insurance coverage under the Affordable Care Act (ACA) have made statements to the effect that EDs have been jammed with the uninsured and that paying for the uninsured population's emergency care has burdened the health care system as a result of the expense of that care. It has therefore been surprising to many to encounter evidence that insurance coverage increases ED use instead of decreasing it...
December 2017: Health Affairs
https://www.readbyqxmd.com/read/29198834/evaluation-of-colorectal-cancer-screening-in-federally-qualified-health-centers
#17
Kara S Riehman, Robert L Stephens, Joenell Henry-Tanner, Durado Brooks
INTRODUCTION: Screening for colorectal cancer in average-risk adults is recommended beginning at age 50 years and continuing until age 75 years. This study was conducted to provide evidence for the effectiveness of an American Cancer Society grant program promoting colorectal cancer screening by implementing evidence-based interventions proven to increase screening rates. METHODS: Analysis compared colorectal cancer screening rates in 77 grant-funded federally qualified health centers between 2013 and 2015 to those of a sample of 77 nonfunded federally qualified health centers selected using a genetic matching technique...
November 23, 2017: American Journal of Preventive Medicine
https://www.readbyqxmd.com/read/29198642/caring-for-undocumented-immigrants-with-kidney-disease
#18
Rajeev Raghavan
The care of dialysis-dependent undocumented immigrants exemplifies a problem at the crux of 2 US national agendas: immigration and health care reform. Undocumented immigrants represent 3% of the US population and 27% of the uninsured, and an estimated 6,500 individuals are dialysis dependent. With no uniform national policy, an estimated 30% to 50% of these individuals receive treatment only in life-threatening situations (emergent dialysis). Since 2005, about 400 undocumented immigrants have received a kidney transplant (>70% living)...
November 30, 2017: American Journal of Kidney Diseases: the Official Journal of the National Kidney Foundation
https://www.readbyqxmd.com/read/29192307/trends-in-cancer-survival-by-health-insurance-status-in-california-from-1997-to-2014
#19
Libby Ellis, Alison J Canchola, David Spiegel, Uri Ladabaum, Robert Haile, Scarlett Lin Gomez
Importance: There have been substantial improvements in the early detection, treatment, and survival from cancer in the United States, but it is not clear to what extent patients with different types of health insurance have benefitted from these advancements. Objective: To examine trends in cancer survival by health insurance status from January 1997 to December 2014. Design, Setting, and Participants: California Cancer Registry (a statewide cancer surveillance system) data were used to estimate population-based survival by health insurance status in 3 calendar periods: January 1997 to December 2002, January 2003 to December 2008, and January 2009 to December 2014 with follow-up through 2014...
November 30, 2017: JAMA Oncology
https://www.readbyqxmd.com/read/29190406/development-of-a-multifaceted-health-disparities-curriculum-for-medical-residents
#20
Ashley H Noriea, Nicole Redmond, Rebekah A Weil, William A Curry, Monica E Peek, Lisa L Willett
BACKGROUND AND OBJECTIVES: Health disparities education is required during residency training. However, residency program directors cite numerous barriers to implementing disparities curricula, and few publications describing successful disparities curricula exist in the literature. In this report, we describe the development, implementation, and early evaluation of a longitudinal health disparities curriculum for resident physicians. We provide resource references, process, and didactic toolkits to facilitate use by other residency programs...
November 2017: Family Medicine
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